Provider Demographics
NPI:1245010404
Name:PALOME CHILD AND FAMILY SPECIALISTS LLC
Entity type:Organization
Organization Name:PALOME CHILD AND FAMILY SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:E
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MED
Authorized Official - Phone:719-651-8928
Mailing Address - Street 1:5265 N ACADEMY BLVD STE 1800
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-4061
Mailing Address - Country:US
Mailing Address - Phone:719-571-9950
Mailing Address - Fax:719-635-9946
Practice Address - Street 1:510 W. MIDLAND AVE.
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863
Practice Address - Country:US
Practice Address - Phone:719-565-8423
Practice Address - Fax:719-635-9946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-04
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty